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Updated: Jan 28, 2026

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微超声波对前列腺癌查的价值:一个回顾性的现实世界的可行性研究
Johann Jakob Wendler1,2, Jonas Bechstein1, John Buckendahl3
1Clinic of Urology, Urooncology and Robotic and Focal Therapy, Medical Faculty of University Magdeburg and University Hospital Magdeburg A. ö. R. (University Medicine Magdeburg, UMM), Magdeburg, Germany.
Prostate cancer and prostatic diseases
|January 26, 2026
概括
高分辨率微超声波 (MUS) 与PSA密度 (PSAD) 结合,有效地分层了前列腺癌 (PCa) 风险. 这种方法大大减少了不必要的活检和机会性查设置中的过度诊断.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗成像医学成像
- 在瘤学瘤学.
背景情况:
- 前列腺癌 (PCa) 查正在演变,成像发挥着至关重要的作用.
- 高分辨率29 MHz微超声波 (MUS) 是MRI用于PCa查的可行替代方案.
- 这项研究是PROSTAMUS试验 (DRKS/WHO注册) 的一部分.
研究的目的:
- 为了评估PSA密度 (PSAD) 修改的微超声波 (MUS) 对于前列腺癌风险分层的疗效.
- 为了比较PSAD修饰的MUS与基于PSA和基于MRI的传统活检指示的性能.
- 评估MUS在减少机会性查中的过度诊断和不必要的活检方面的潜力.
主要方法:
- 追溯分析682名接受MUS和PSA测试的男性.
- 活检和MRI按照指导方针进行.
- 定义的PSAD修饰的负MUS (PRI-MUS类别1-3;PSAD<0.15 ng/mL2) 和正MUS (PRI-MUS类别3与PSAD≥0.15 ng/mL2,类别4-5).
主要成果:
- 鉴定了3种临床显著的PCa (csPCa) 和4种非临床显著的PCa (ncsPCa).
- 检测到15个csPCa和7个ncsPCa的PSAD修饰的阳性MUS (n=88).
- 这种方法显示,与标准指示相比,过度诊断减少了6.29倍,负面活检/ncsPCa减少了7.22倍.
- 经过PSAD修改的PRI-MUS显示了cspca检测的83.3%的灵敏度和89.7%的负预测值.
结论:
- 带有PSAD的微超声波 (MUS) 允许有效地分层前列腺癌风险.
- 这种成像模式支持机会性查,可以减少过度诊断和不必要的程序.
- MUS在指导活检决策和在某些情况下潜在地减少MRI的需求方面表现有前途.
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